A woman is at 32 weeks’ gestation. Her fundal height measurement at this clinic appointment is 26 centimeters. After reviewing her ultrasound results, the health care provider asks the nurse to schedule the client for a series of ultrasounds to be done every 2 weeks. The nurse should ensure that the client understands that the main purpose for this is to:
Select one:
A.
Rule out a suspected hydatidiform mole.
B.
Assess for congenital anomalies.
C.
Determine fetal presentation.
D.
Monitor fetal growth.
The Correct Answer and Explanation is:
The correct answer is D. Monitor fetal growth.
Explanation:
Fundal height is a key measurement in assessing fetal growth and development during pregnancy. At 32 weeks’ gestation, the expected fundal height typically corresponds to the number of weeks of gestation, plus or minus 2 centimeters. In this case, the fundal height is 26 centimeters, which is significantly lower than what is expected for 32 weeks. This discrepancy could indicate a potential issue with fetal growth.
When there is a notable deviation from expected fundal height measurements, healthcare providers may use ultrasound to gain more detailed insights. Regular ultrasounds are particularly useful for monitoring fetal growth to ensure that the fetus is developing appropriately and to identify any potential issues early.
The primary purpose of scheduling a series of ultrasounds every 2 weeks in this context is to monitor fetal growth. This allows the healthcare provider to track the fetus’s growth over time and determine if there are any signs of intrauterine growth restriction (IUGR) or other growth-related concerns. Consistent monitoring helps in making informed decisions regarding further management of the pregnancy, including potential interventions if necessary.
Let’s briefly consider why the other options are less relevant in this scenario:
- A. Rule out a suspected hydatidiform mole: A hydatidiform mole is a type of gestational trophoblastic disease that usually presents with abnormal bleeding, a very high fundal height, and a larger-than-expected uterus. The current scenario doesn’t suggest these symptoms, and hydatidiform moles are generally identified earlier in pregnancy, not typically at 32 weeks.
- B. Assess for congenital anomalies: While ultrasounds can be used to assess for congenital anomalies, this is usually done in the earlier stages of pregnancy, such as during the anatomy scan around 18-20 weeks. By 32 weeks, the focus shifts more towards monitoring fetal growth and well-being rather than assessing for congenital anomalies.
- C. Determine fetal presentation: Determining fetal presentation, such as whether the fetus is breech or cephalic, is typically done closer to delivery or during labor, not through regular ultrasounds when there are concerns about fundal height.
In summary, the main purpose of scheduling the client for a series of ultrasounds every 2 weeks is to monitor fetal growth to ensure that the fetus is developing as expected and to address any potential issues promptly.